Individual provider Active NPI

Zachary Gavin Tanenbaum

  • Otolaryngology Physician
  • Cleveland, OH
National Provider Identifier
1093383085
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
35.155764 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 444-2200
Fax
(216) 444-2200
NPI assigned
Jun 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35.155764 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707000147 IA Order and Referring Only - OtolaryngologyPractitioner - Otolaryngology 3072915578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1093383085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2200",
            "fax_number": "216-444-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2200",
            "fax_number": "216-444-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANENBAUM",
        "first_name": "ZACHARY",
        "middle_name": "GAVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-15",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35.155764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.